How to Appeal a Denied Insurance Claim in Florida

If your property insurance claim was denied in Florida, you’re not alone—and you’re not out of options. Every year, thousands of Florida homeowners face the frustrating reality of having their legitimate claims rejected by insurance companies. The good news? You have the legal right to appeal a denied insurance claim in Florida, and with the right approach, many denials can be successfully overturned.

This comprehensive guide will walk you through the entire appeal process, explain your rights under Florida law, and help you understand when it’s time to seek legal assistance. Whether your claim was denied due to a technicality, disputed damage assessment, or alleged policy violation, we’ll show you exactly what steps to take next.

Why Insurance Claims Get Denied in Florida

Before you can effectively appeal a denied insurance claim, it’s essential to understand why insurance companies deny claims in the first place. Florida has one of the most challenging insurance markets in the country, and insurers frequently look for reasons to minimize or deny payouts.

Common Reasons for Claim Denials

• Incomplete or inaccurate documentation: Missing photos, incomplete claim forms, or inconsistent information
• Late filing: Florida law requires claims to be filed within specific timeframes (typically 1 year for property claims under recent reforms)
• Policy exclusions: Damage from excluded perils like floods (requiring separate flood insurance) or wear and tear
• Disputed cause of damage: Insurers claiming damage resulted from maintenance issues rather than covered events
• Pre-existing damage allegations: Claims that damage existed before the policy period or covered event
• Failure to mitigate: Allegations that you didn’t take reasonable steps to prevent further damage

Step-by-Step Guide to Appeal a Denied Insurance Claim in Florida

Follow these steps to effectively challenge your denied property insurance claim in Florida:

Step 1: Review the Denial Letter Carefully

Florida insurance companies are legally required to provide a written explanation for any claim denial. This letter is your roadmap for the appeal process. Look for:

• The specific reason(s) for denial
• Policy sections or exclusions cited
• Deadlines for filing an appeal
• Instructions for the appeals process

Step 2: Request Your Complete Policy and Claim File

You have the right to obtain a complete copy of your insurance policy and your entire claim file, including the adjuster’s notes and any reports. This documentation is essential for identifying weaknesses in the insurer’s denial rationale.

Step 3: Gather Supporting Evidence

Build the strongest possible case by collecting:

• Photographs and videos documenting the damage (with timestamps)
• Independent contractor repair estimates
• Expert reports from engineers or public adjusters
• Weather reports or official storm data (for hurricane/storm claims)
• Maintenance records showing proper upkeep
• All correspondence with the insurance company

Step 4: Write a Formal Appeal Letter

Your appeal letter should be clear, professional, and thorough. Include:

• Your policy number and claim number
• A point-by-point rebuttal of each denial reason
• References to specific policy language supporting your claim
• A list of all attached supporting documentation
• A clear statement of what you’re requesting (claim approval and payment amount)

Step 5: Submit Your Appeal Within Deadlines

Most Florida insurers require appeals within 30 to 60 days of the denial. Send your appeal via certified mail with return receipt requested, and keep copies of everything you submit.

Step 6: Follow Up Persistently

Document every interaction with your insurance company. Note the date, time, representative’s name, and summary of each conversation. Under Florida law (F.S. §627.70131), insurers must acknowledge claims within 14 days and make payment decisions within 90 days.

Your Legal Options Under Florida Law

If your internal appeal is unsuccessful, Florida law provides several additional avenues to pursue your claim:

File a Complaint with the Florida Department of Financial Services

You can file a complaint online, by phone (877-693-5236), or by email at consumer.services@myfloridacfo.com. While the Department cannot force an insurer to pay a claim, complaints often prompt faster responses and can document a pattern of bad faith behavior.

Request Mediation or Appraisal

Many Florida insurance policies include provisions for mediation or appraisal to resolve disputes. The appraisal process allows both parties to hire independent appraisers to determine the amount of loss.

Pursue a Bad Faith Claim

Under Florida Statute §624.155, if your insurer unreasonably denies, delays, or underpays a valid claim, you may have grounds for a bad faith lawsuit. Bad faith claims can result in additional damages beyond the original claim amount.

When to Hire a Florida Property Damage Attorney

While you can navigate the initial appeal process yourself, there are situations where hiring an experienced Florida insurance claim attorney is strongly recommended:

• Your claim involves significant damages (over $10,000)
• The insurer is acting in bad faith or using delay tactics
• Your appeal was denied
• You’re dealing with complex coverage disputes
• The statute of limitations is approaching
• You’re feeling overwhelmed by the process

At Krapf Legal, our property damage attorneys have extensive experience fighting denied insurance claims throughout Florida. We understand the tactics insurers use and know how to build compelling cases that get results.

Florida Insurance Claim Appeal Timeline

Understanding key deadlines is critical when you appeal a denied insurance claim in Florida:

Frequently Asked Questions About Denied Insurance Claims in Florida

Can I appeal a denied insurance claim more than once?

Yes. Many insurers allow multiple levels of internal appeals, especially if you provide new or additional evidence with each attempt. However, be mindful of deadlines and the statute of limitations for filing a lawsuit.

How long does the appeal process take?

Internal appeals typically take 30-60 days for a decision. If you escalate to litigation, the process can take several months to over a year depending on case complexity.

Do I need a lawyer to appeal a denied claim?

While you can start the appeal process yourself, an experienced attorney significantly increases your chances of success, especially for complex claims or when bad faith is involved.

What is bad faith insurance denial?

Bad faith occurs when an insurance company unfairly denies a valid claim, fails to properly investigate, unreasonably delays payment, or otherwise fails to uphold its obligations under the policy. Florida law allows policyholders to sue for bad faith and recover additional damages.

What if my insurer won’t respond to my appeal?

If your insurer fails to respond within required timeframes, document the delays and consider filing a complaint with the Florida Department of Financial Services. Persistent non-responsiveness may constitute bad faith.

Take Action on Your Denied Insurance Claim Today

Having your insurance claim denied in Florida doesn’t mean the fight is over. By understanding the appeal process, gathering strong evidence, and knowing your legal rights, you can challenge unfair denials and pursue the compensation you deserve.

If you’re struggling with a denied property insurance claim, the experienced attorneys at Krapf Legal are here to help. We’ve successfully fought insurance companies throughout Florida and recovered millions for our clients.

Contact Krapf Legal today for a free consultation. Call us or fill out our online form to discuss your denied claim and learn how we can help you get the settlement you deserve.